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[Stellajane]

A question to our scientific people.

Why, if we can use Utrogestan vaginally (ie absorbed via skin) can't progesterone be applied to other areas of skin? Is it purely down to location that makes vaginal prog effective?

[Joaniepat]

The lining of the vagina (the vaginal mucosa) is quite different from the skin on the external parts of your body. When you think about it, the skin on your body is more of a protective barrier, so substances are not so easily absorbed through it. Its structure is quite different from the lining of the vagina. Hope this helps.
JP x

[dangermouse]

All topical products need a carrier ingredient.

Transdermal (skin) progesterone use a cream type carrier, like Versabase.

Sublingual (mucous membranes - gums or genitals) products usually have a more oily/sticky type of carrier, like Vitamin E oil.

Oils can be absorbed by the skin but to a lesser degree.

[Hurdity]

Absorption of progesterone through the vagina is not transdermal - it is transvaginal  - because as Joaniepat says - the lining is different and it is counted as skin.

The other things is that the aim of vaginal administration of progesterone is not absorption (through the vaginal mucosa - this is incidental) but delivery directly to the womb, I presume by diffusion ie it travels up the vagina through the cervix and directly to the uterus. This is the uterine first pass effect and is what makes it so effective. Progesterone from systemic absorption though the vaginal mucosa is transported in the blood stream and delivered indirectly in this way ( like transdermal oestrogen).

Also progesterone is a very unstable molecule so the formulations to deliver it to the body are more limited - so it can't be made into a patch for example. The biochemistry is complicated and beyond me - it can be delivered in gels, micronised in suspension, waxy capsules, creams etc but not as a patch due to its structure I presume.

If it were to be delivered transdermally as a cream then a formulation would need to be produced at a concentration that consistently delivers a given range of progesterone levels to women in order to protect the womb. Because progesterone is given chiefly either as a fertility aid or to protect the womb as part of HRT, then it is crucial to ensure any method of delivery actually guarantees to do this safely. The medical establishment can't put women at risk using a method that is possibly too variable?

Other hormones delivered through creams  like testosterone (Androfeme) for example - it is given therapeutically so doesn't matter if we don't all get the same amount or if it's not absorbed properly.

What I don't understand is why, if progesterone can be produced in a gel ie Crinone (is this transparent??) - why a formulation can't be developed that can be absorbed through the skin using different carrier ingredients? I presume again that it might not be reliable enough or consistent enough to protect the womb?

Thinking aloud here Stellajane!

Hurdity x

[EnglishRose]

Absorption of progesterone through the vagina is not transdermal - it is transvaginal  - because as Joaniepat says - the lining is different and it is counted as skin.

The other things is that the aim of vaginal administration of progesterone is not absorption (through the vaginal mucosa - this is incidental) but delivery directly to the womb, I presume by diffusion ie it travels up the vagina through the cervix and directly to the uterus. This is the uterine first pass effect and is what makes it so effective. Progesterone from systemic absorption though the vaginal mucosa is transported in the blood stream and delivered indirectly in this way ( like transdermal oestrogen).

Also progesterone is a very unstable molecule so the formulations to deliver it to the body are more limited - so it can't be made into a patch for example. The biochemistry is complicated and beyond me - it can be delivered in gels, micronised in suspension, waxy capsules, creams etc but not as a patch due to its structure I presume.

If it were to be delivered transdermally as a cream then a formulation would need to be produced at a concentration that consistently delivers a given range of progesterone levels to women in order to protect the womb. Because progesterone is given chiefly either as a fertility aid or to protect the womb as part of HRT, then it is crucial to ensure any method of delivery actually guarantees to do this safely. The medical establishment can't put women at risk using a method that is possibly too variable?

Other hormones delivered through creams  like testosterone (Androfeme) for example - it is given therapeutically so doesn't matter if we don't all get the same amount or if it's not absorbed properly.

What I don't understand is why, if progesterone can be produced in a gel ie Crinone (is this transparent??) - why a formulation can't be developed that can be absorbed through the skin using different carrier ingredients? I presume again that it might not be reliable enough or consistent enough to protect the womb?

Thinking aloud here Stellajane!

Hurdity x

This is interesting as it wasn't until recently from one of your replies did it occur to me I'm not getting as much prog as I assumed p.

As you know, I've been applying cyclogest (pessary) to my skin after melting it in my hand or in my knickers 😳
The melted substance is very thin but soon dries back to the waxy solution.
Once I rub it into my skin it leaves a layer like Vaseline I guess.

I have no idea how much I've actually been absorbing but my last blood results said
progesterone was 20.
Oestrogen <18
FSH 70

Do you happen to know what the “healthy” serum level for progesterone is in  someone in peri fast approaching meno Hurdity?

[Dancing Queen]

Now I`m a bit confused ...  I thought there was progesterone in my femseven sequi patches ... is levonorgestrel not a synthetic progesterone? Well that`s what the dr told me but don`t think she had much idea.. 

[BlueButterfly]

The contraceptive patch also contains a progestin as well. It is in combined patch preparations...wonder why they wouldn't just give a progesterone only patch? Maybe just not much of a market for it?

[Hurdity]

Now I`m a bit confused ...  I thought there was progesterone in my femseven sequi patches ... is levonorgestrel not a synthetic progesterone? Well that`s what the dr told me but don`t think she had much idea..

Hi when talking about progesterone I do mean progesterone (which is a progestogen). The others are synthetic progestogens so although in common parlance we do call them progesterone they aren't actually progesterone IYSWIM?! I was referring to progesterone not synthetic progestogens....because this is what the thread was about - but I understand it seems confusing!!!

Just to remphasis progesterone itself cannot ( or not yet) be made into a patch. All the patch HRT types contain a synthetic progestogen incorporated.

Not sure why "they" don't do the (synthetic) progestogen only ones like you suggest BlueButterfly? Presumably as you say, for commerical reasons.

Hurdity x

[Hurdity]

This is interesting as it wasn't until recently from one of your replies did it occur to me I'm not getting as much prog as I assumed p.

As you know, I've been applying cyclogest (pessary) to my skin after melting it in my hand or in my knickers 😳
The melted substance is very thin but soon dries back to the waxy solution.
Once I rub it into my skin it leaves a layer like Vaseline I guess.

I have no idea how much I've actually been absorbing but my last blood results said
progesterone was 20.
Oestrogen <18
FSH 70

Do you happen to know what the “healthy” serum level for progesterone is in  someone in peri fast approaching meno Hurdity?

Progesterone levels are usually only measured for fertility reasons or to check if someone is ovulating. In the first part of the menstrual cycle they are extremely low (as they are in post-menopause unless taking HRT and progesterone itself) and then rapidly rise after ovulation. The levels you record will be presumably due to either ovulation ( your own prog) if you are still ovulating and are peri-menopausal or some absorption from the Cyclogest. During the fertile years or in peri-menopause it will depend when in the cycle prog levels are measured.

Hurdity x

[Ladybt28]

wow I am always blown away when we get posts and replies like this ladies - we really need to pat ourselves on the backs for the wealth of really technical knowledge that is here and which comes in so quickly. Every GP should be automatically sent these technical questions and the answers that come in some sort of NHS messaging/information service - they might actually flaming learn something!!

[Hurdity]

The thing is Ladybt - it's not even technical ie involves fairly basic knowledge of menstrual cycle etc. However GPs are just that -generalists, so maybe not surprising that they don't know as much in depth as some of us on here who have read so much about it over the years (and not for example about diabetes, heart conditions etc!). It is of course why we need to have more specialist menopause clinics on NHS and not the private ones that keep springing up and are over-subscribed - however good they are!

Hurdity x

[Ladybt28]

Do you know what Hurdity - I reckon we could also spout some pretty knowledgeable and useful stuff on other conditions as well.  Like thyroid issues, fibro, heart conditions, blood pressure, BMI, planter fasciitis.  GPs drive me mad because they don't read anything in the latest journals it seems, nor do they keep up with any basic stuff which is the wider world in general where you dont actually have to go looking- its just there in front of your nose.  How can you sit in front of people day to day and really not know your stuff about fairly basic medical conditions that present time after time.  Newspapers are always having specialist sections about the "most current conditions" and "New treatments" and stuff is on the news and on the radio. Personally I think they can't read and they are all deaf! (can anyone guess they are NOT my favourite people! ha)